Direct Funded Home Care for Older People in Canada
Most older people want the choice to “age in place,” at home and in community, rather than having prolonged hospital stays or moving into residential care facilities. A growing policy mechanism to support this demand is “directly-funded” (DF) or self-managed home care. DF home care provides individuals with cash to hire and manage attendants or arrange their own services instead of receiving government provided services. This model is championed for increasing autonomy, cultural sensitivity, cost-effectiveness, and even improving health outcomes. Yet, it is also an example of neoliberal downshifting and contributes to precarious forms of work. Rather than a program evaluation, our research is an in-depth, qualitative exploration of the question: How do DF programs shape the experiences, working conditions, policy landscape, and theoretical implications of home care in Canada? This examination attends to inequalities related to disability, gender, racialization and immigration.